A new study published in The Lancet reveals that many adults over 40 living with obesity now have cholesterol and blood pressure levels indistinguishable from those of healthy weight, primarily due to widespread use of statins and blood pressure medications. In some cases, individuals with obesity were found to be 'better off' than their normal-weight counterparts.
Convergence of Cardiovascular Risk Factors
The research, which analyzed data from nearly 1 million adults aged 20 to 79 across seven countries—England, Japan, South Korea, Taiwan, Thailand, Finland, and the US—examined blood pressure, cholesterol levels, and BMI from 110 health surveys conducted between 1990 and 2024. The team observed that unhealthy cholesterol levels and blood pressure declined over time, especially among those aged 40 and older. The declines were more pronounced in people with obesity, leading to a convergence of these risk factors between obesity and normal BMI in older adults.
Professor Majid Ezzati from Imperial College London's School of Public Health stated: 'Our study suggests that, in high-income countries, taking medication to lower blood pressure and cholesterol has helped middle-age and older adults lower their cardiovascular risk to levels that are similar to people with normal BMI.'
Implications for Weight-Loss Medications
Experts emphasize that these findings are crucial as weight-loss medications gain popularity. The study provides a snapshot of cardiovascular health among those likely to be prescribed such drugs. Professor Ezzati added: 'At a time that weight-loss medications are becoming more widely used, our results give a picture of the cardiovascular health of people likely to be prescribed them, which allows the healthcare system to understand how blood pressure and cholesterol treatments benefit the population alongside weight-loss medications.'
Age-Related Differences
However, the study found that in adults under 40, those with obesity still had higher levels of bad cholesterol and higher blood pressure compared to their healthy-weight peers. Co-author Yse d'Ailhaud de Brisis from Imperial College London noted: 'While good news for older adults with obesity, our results suggest that cardiovascular health risks remain higher for adults under 40 than for their counterparts with a normal BMI. Early lifestyle interventions, screening and, when appropriate, medication in this younger group should be considered to prevent long-term cardiovascular complications linked to obesity.'
Caution from Experts
Professor Edward Gregg from Imperial College London stressed that the findings do not mean obesity no longer poses health risks: 'It doesn't mean that obesity does not still increase your risk of other outcomes.' Professor Bryan Williams, chief scientific and medical officer at the British Heart Foundation, commented: 'This study highlights a powerful public health success story – it shows just how effective modern treatments for blood pressure and cholesterol have become, with many people over 40 with obesity now reaching levels similar to those with a healthy weight. But we must not lose sight of the bigger picture. These medications are needed because of the adverse effects of obesity on cardiovascular disease risk. Moreover, obesity still affects the body in many other ways and increases the risk of other health problems, including diabetes, kidney disease and some cancers.'
